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Forms Can. Be Submitted. via Email to lodellgtownofwappin erny.�ov or in personlvia mail to 201vliddlebush
Rd Wappingers Falls, *,iY 12590
FOR INTERNAL USE ONLY
Received. by: Joseph P. Paoloni -1
Lynn O'Dell 1
Lori McConologue 34
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
L
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
L.!
FIRE INSPECTOR
HIGHWAY
L
RECEIVER OF TAXES
L
RECREATION
L
SUPERVISOR
L
TOWN CLERK
L
WATER/SEWER
L
DOG CONTROL OFFICER
TOWN ENGINEER
L
TOWN ATTORNEY
L
TOWN OF WAPPINGER
Application for Public Access to Records
REO E T
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.:,
FOR DEPARTMENT USE ONLY
Date Received by Dept 17 / 1 f
Department Head approval:
Date Applicant Contacted: 9 0 1 f 1��/
Date FOIL,. fulfilled or denied:
Closed by:
Date:
ff!
Notes:
Amount Due: Pages for a total of $
Name: _ '.. s' -h r l ._-1 i"Z.. 2 check here if you are
Address: �l 'r requesting that the records
0 A I C . ) -2-6'10 be mailed to this address.
Agency or firm:
Telephone #: 5 -?V'
,. FAX #: ( _
Email address:
SPECIFIC DESCIII" fI OF RECORD:
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FORMAT OF RECORD (if available)
1 I request to be notified when I can come to inspect the record(s) described above
L I request copies of the records described above and agree to pay the cost of such records in
accordance with the fee schedule on the back of this application
Lm I request that the records be sent via e-mail to the address listed above
F I request that the records be faxed to the number listed above